Comparison of the benefits of celecoxib combined with anticancer therapy in advanced non-small cell lung cancer: A meta-analysis

Abstract

Background: Studies have reported that advanced NSCLC benefits from celecoxib combined with systematic treatment. However, the optimal combination with different treatments remains unclear. A meta-analysis was conducted to explore treatment combinations. Methods: We searched the relevant literature via PubMed, EMBASE, the Cochrane Library and PMC. The data for the overall response rate (ORR), overall survival (OS), progression-free survival (PFS), and adverse effects were obtained. Subgroup analysis was performed according to the treatment pattern. Statistical analyses were carried out using Review Manager 5.3 software. Results: A total of 18 eligible studies were included, with 1178 advanced NSCLC patients. Subgroup analysis revealed that celecoxib combined with chemotherapy or tyrosine kinase inhibitors (TKIs) significantly increased the ORR, with no significant difference between the two groups. Celecoxib combined with chemotherapy improved OS-6 (OR=0.65, 95% CI 0.59-0.71, P<0.001), while OS-6 was not changed with celecoxib combined with TKIs (OR=0.53, 95% CI 0.31-0.73, P=0.82). Differences were apparent between the chemotherapy and TKIs regarding OS-6 (P=0.0392). Celecoxib combined with chemotherapy significantly prolonged OS-12 (OR=0.39, 95% CI 0.33-0.45, P<0.001). In terms of OS-12, there was no significant improvement when celecoxib was combined with radiotherapy or TKIs. Celecoxib combined with chemotherapy or TKIs significantly improved PFS-6 and PFS-12, with no obvious difference in terms of PFS between the two groups. Additionally, celecoxib combined with chemotherapy or TKI treatment increased the incidence of adverse events, with no significant differences between the two groups. Conclusions: Celecoxib combined with chemotherapy or TKIs improved the ORR, with no significant differences between the two groups. In terms of OS, celecoxib combined with chemotherapy was superior to TKIs or radiotherapy. Accordingly, celecoxib combined with chemotherapy increased hematological toxicity and cardiovascular events.

Biomarkers for Malignant Pleural Mesothelioma—A Novel View on Inflammation

“…In addition, the therapeutic effect of COX-2-inhibitors such as celecoxib has already been studied in other cancer types extensively [63]. However, COX-2 is not a routine target in modern oncology due to controversial results, e.g., for colorectal [64][65][66] and lung cancer [67,68]. For MPM on the contrary COX-2-inhibitors achieved promising results in vitro [35,57,69,70] and in vivo [36,71].…”

PACER lncRNA regulates COX-2 expression in lung cancer cells

“…Celecoxib is a selective inhibitor of COX-2. Clinical trials targeting patients with advanced NSCLC showed that celecoxib is effective in combination with immune checkpoint inhibitors and targeted therapies but also increases the risk of adverse effects such as hematological toxicity and cardiovascular complications [ 56 ]. Additional strategies to regulate COX-2-derived PGE 2 are essential to optimize and maximize the clinical benefits of non-targeted therapies such as NSAIDs.…”

The Inflammatory Profile of the Tumor Microenvironment, Orchestrated by Cyclooxygenase-2, Promotes Epithelial-Mesenchymal Transition

“…For example, Zhang et al showed that the crucial signaling altered in NSCLC was EGF receptor (EGFR). Also, they demonstrated that the use of CXB improves the overall response rate (ORR) ( 146 ). Therefore, more studies are required to describe the best therapeutic regimen according to the potential synergism between chemotherapeutic or immunotherapeutic strategies with CXB as an adjuvant.…”